SGLT2抑制剂在MASLD和T2DM患者中的临床结果

IF 7.4 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice Pub Date : 2025-09-24 DOI:10.1016/j.diabres.2025.112918

Jheng-Yan Wu , Hsuan-Yuan Chang , Yu Tsung , Yu-Min Lin

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引用次数: 0

摘要

背景和目的代谢功能障碍相关的脂肪变性肝病（MASLD）经常与2型糖尿病（T2DM）共存，增加了心血管、肾脏和肝脏并发症的风险。药物选择仍然有限。本研究旨在评估与二肽基肽酶-4抑制剂（DPP4is）相比，钠-葡萄糖共转运蛋白-2抑制剂（SGLT2is）与MASLD和T2DM患者一年临床结局之间的关系。方法和结果：这项回顾性队列研究使用了TriNetX全球研究网络中147家医疗机构的数据。在2013年1月1日至2025年2月28日期间，患有MASLD和T2DM的成人开始SGLT2is或DPP4is。配对后，每组纳入10232例。主要转归是全因死亡率、主要不良心血管事件（MACE）、肾脏事件（MAKE）和肝脏事件（MALO）的综合结果。SGLT2is与较低的综合结局（HR, 0.65）和所有单独成分的风险相关。亚组分析和敏感性分析结果一致。结论：在MASLD和T2DM患者中，与dpp4相比，SGLT2is与较低的重大临床事件风险相关，支持其潜在的治疗作用，有待随机试验的证实。

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Clinical outcomes of SGLT2 inhibitors among patients with MASLD and T2DM

Background and Aims

Metabolic dysfunction-associated steatotic liver disease (MASLD) frequently coexists with type 2 diabetes mellitus (T2DM), increasing the risk of cardiovascular, renal, and hepatic complications. Pharmacologic options remain limited. This study aimed to evaluate the association between sodium-glucose cotransporter-2 inhibitors (SGLT2is) and one-year clinical outcomes in patients with MASLD and T2DM, compared to dipeptidyl peptidase-4 inhibitors (DPP4is).

Approach and Results

This retrospective cohort study used data from 147 healthcare organizations in the TriNetX global research network. Adults with MASLD and T2DM initiating SGLT2is or DPP4is between January 1, 2013, and February 28, 2025, were identified. After matching, 10,232 patients were included in each group. The primary outcome was a composite of all-cause mortality, major adverse cardiovascular events (MACE), kidney events (MAKE), and liver outcomes (MALO). SGLT2is were associated with lower risks of the composite outcome (HR, 0.65) and all individual components. Subgroup and sensitivity analyses yielded consistent results.

Conclusions

Among patients with MASLD and T2DM, SGLT2is were associated with lower risks of major clinical events compared to DPP4is, supporting their potential therapeutic role pending confirmation in randomized trials.

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来源期刊

Diabetes research and clinical practice 医学-内分泌学与代谢

CiteScore

10.30

自引率

3.90%

发文量

862

审稿时长

32 days

期刊介绍： Diabetes Research and Clinical Practice is an international journal for health-care providers and clinically oriented researchers that publishes high-quality original research articles and expert reviews in diabetes and related areas. The role of the journal is to provide a venue for dissemination of knowledge and discussion of topics related to diabetes clinical research and patient care. Topics of focus include translational science, genetics, immunology, nutrition, psychosocial research, epidemiology, prevention, socio-economic research, complications, new treatments, technologies and therapy.